Healthcare Provider Details

I. General information

NPI: 1053569004
Provider Name (Legal Business Name): MARIA C. STOKES MED, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 HOOVER RD
JEFFERSON CITY MO
65109-0800
US

IV. Provider business mailing address

PO BOX 844715
KANSAS CITY MO
64184-4715
US

V. Phone/Fax

Practice location:
  • Phone: 573-632-4321
  • Fax:
Mailing address:
  • Phone: 417-761-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2004024774
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: